Canad. Med. Ass. J.
Feb. 11,1967, vol. 96
The Effects of Hypnotherapy on Homosexuality
PETER ROPER, M.D., Ch.B., D.P.M., Montreal
Fifteen homosexuals were treated with hypnosis.
The patients were selected from a general psychi
atric practice and had a long history of confirmed
homosexual behaviour and showed no evidence of
organic or psychotic illness. The type of hypnotic
induction attempted in all cases is described. In
those where a satisfactory depth of hypnotic trance
was achieved a change in sexual orientation was
suggested to the patient.
Before therapy, each patient was assessed using
the Kinsey scale. Results were evaluated in terms
of the patient's subsequent behaviour and his sub
jective feelings. Of the 15 patients, three showed
no improvement, four showed a mild improvement
and eight showed a marked improvement. There
was a significant correlation between the depth
of hypnosis achieved and the therapeutic outcome.
Those patients who reached a deep level of hypnotic
trance were most likely to show a marked improve
ment. There were no significant correlations with
other factors such as degree of homosexuality as
measured on the Kinsey scale and the patient's
marital status.
Treatment of homosexuals with hypnosis may
produce more satisfactory results than those obtain-
able by other means. The best results are likely
to be achieved in patients who are good hypnotic
subjects.
THEfraught "cures" of homosexual behaviour is
treatment
with difficulty for many
of measurable im
reasons.
Reports of or even
provement are rare, and many psychiatrists be
lieve that the condition is unlikely to show any
basic change regardless of methods used. Treat
ment is often directed at other neurotic aspects
of the patient's personality in an attempt to help
him "live with his problem". The psychiatrist
may even encourage homosexual activity in a
patient with these inclinations, if this can be
expected to prevent a general deterioration of
his neurosis.
It is not always clear why some psychiatrists
do not try to change this abnormal behaviour, or
why they apparently resist the efforts of others
in this direction. These attitudes may be due to
the dislike and even abhorrence of homosexual
activity shared by the rest of society and also
by the acceptance of preconceived ideas about
the futility of treatment. Increasing evidence
of successful treatment of homosexual behaviour
would undoubtedly improve these attitudes.
Modern literature contains few references to
successful treatment; two different approaches
are those of Hadfield5 and James.6 More recent
From the Allan Memorial Institute of Psychiatry, McGill
University, Montreal, Quebec.
Roper: Homosexuality 319
On a traite 15 homosexuels au moyen de Fhypnose.
Ces sujets ont ete choisis parmi des malades fre-
quentant uneclinique de psychiatrie generale et
avaient tous de longs antecedents de comportement
homosexuel, tout en ne presentant aucun signe de
maladie organique ou de psychose. L'auteur dcrit
le type d'induction hypnotique employ, dans tous les
cas. Chez les malades ou on tait parvenu a obtenir
une transe hypnotique de profondeur satisfaisante,
on suggera au sujet de changer d'orientation
sexuelle.
Avant le traitement, chaque malade fut evalue'
d'apres les criteres de Fechelle de Kinsey. Les re
sultats furent evalues en fonction de leur comporte
ment subsequent et d'apres les propres sentiments
subjectifs du patient. Sur les 15 sujets, trois ne
furent pas ameliores, quatre presentaient une legere
amelioration et huit une amelioration tres nette.
II y avait une concordance notable entre la profon
deur de la transe hypnotique realisee et les resultats
therapeutiques. C'est surtout les patients ou une
hypnose profonde avait pu etre atteinte qu'une
amelioration notable etait le plus susceptible de se
produire. II n'existait aucune correlation avec
d'autres facteurs, comme le degre* d'homosexualitl,
mesuree d'apres F6chelle de Kinsey, ni avec les
statut marital.
Le traitement d'homosexuels par Fhypnose peut
donner des resultats plus favorables que ceux qu'on
obtient de tout autre moyen. Les resultats sont
d'autant meilleurs que le patient est un bon "sujet"
pour Fhypnose.
work using the techniques of behaviour therapy
has shown some success as described by Thorpe
et al.,12 Feldman and MacCulloch,1 and Gold
and Neufeld.3 Hypnosis was used to treat homo
sexuality in the nineteenth century; Krafft-
Ebing7 claimed some success. In 1895 Schrenck-
Notzing10 reviewed the treatment results with
hypnosis and noted that those who achieved a
deep hypnotic trance responded better.
Except for a paper by Gonzaga,4 there have
been no recent reports of hypnotic treatment in
homosexual behaviour. If the results reported
earlier were so good, it is difficult to understand
why the technique was not used more between
1900 and 1960.
The use of hypnosis in exhibitionism has been
reported earlier.8 This work led to consideration
of changing homosexual behaviour by similar
methods.
Experience in general clinical psychiatry em
phasizes the importance of recognizing ofthat
homosexual behaviour may be a symptom an
underlying illness and hence part of a more
general picture of disintegrated and irrespons-
ible behaviour. Failure to recognize this fact may
explain the evident confusion in our concepts of
320 Roper: Homosexuality
its etiology and also the considerable variation
in treatment techniques and the diverse results
reported.
The problem is particularly difficult in the
borderline schizophrenic patient, in whom the
psychotic nature of the illness may not be clearly
apparent at the outset. Special efforts were made
to exclude these patients from the present study.
When those excluded were treated for their
schizophrenic illness, the homosexual behaviour
disappeared along with other symptoms as the
illness remitted.
Selection of Patients
The 15 patients selected for this study had a
long history of confirmed homosexual behaviour
and did not have any detectable underlying
organic or psychotic illness. They were seen in
the general run of psychiatric practice, and no
special effort was made to select them. It was
understandable that the majority of patients had
a reasonably strong motivation to change their
behaviour; this was less apparent in those who
had been referred by the courts or were under
the threat of legal action. However, no exclu-
sions were made on these grounds.
Methods
The standard general psychiatric examination
was carried out and, where indicated, special
tests such as electroencephalograms (EEG); in
addition, special emphasis was placed on the
history of sexual behaviour. This included not
only the determination of factors effecting the
onset of the homosexual behaviour and its sub
sequent continuation, but also an interview
under thiopental sodium (Pentothal) to obtain
additional information and to confirm that al
ready obtained.
The technique of hypnotic induction was the
same as that used in the treatment of exhibition-
ism.8 The patient was treated lying on a couch
and the hypnotic trance was induced by sug-
gestions made as his eyes, opening and closing,
were looking at the ceiling light. These sugges-
tions were that the eyelids would gradually be
come too heavy to open, and as this occurred
a feeling of sleepiness would follow, until a
desire for deep sleep was felt. The depth of
trance was gauged not only by the patient's
response to the suggestions, but also by the
degree of spontaneous posthypnotic amnesia.
In some patients a satisfactory depth of trance
could not be induced.
The'procedure was standardized as much as
possible, but minor variations in technique were
introduced as additional experience was gained.
Canad. Med. Ass. J.
Feb. 11, 1967. vol. 96
As a general rule, when the patient sank into a
deep trance other suggestions of change were
gradually incorporated. Initially these concerned
physical changes in sensation, with feelings of
strength in an arm and hand, the fist becoming
tightly clenched and the arm held rigid. If
subsequent suggestions of raising and lowering
the arm in this rigid position were achieved,
suggestions were incorporated of subjective feel
ings of self-confidence, self-assertion and mas-
culinity.
As the patient's acceptance of these sugges
tions increased, a change in sexual orientation
was increasingly emphasized, with more definite
suggestions about attraction to women and aver-
sion towards men. At the same time, explana
tions of the onset of his homosexual behaviour
were given based on the facts previously
obtained.
These explanations were kept as simple and
straightforward as possible and included state
ments that a certain degree of sexual uncertainty
was normal in the growing-up period, but that,
in his particular case, this had been prolonged
and deviated in a homosexual direction because
of the particular circumstances which affected
him at that time. The subsequent satisfaction of
his sexual desires in a homosexual way, although
unnatural, had beensufficient for the repetition
of this behaviour so that a habit pattern had
become established.
Once this simple formulation had apparently
been accepted during the trance state, it was
incorporated with the suggestions of change
which had been made previously; it was further
suggested that the understanding of the origin
of his problem, together with the feelings of
change, would be sufficient for him to leave
behind the homosexual behaviour and become
more and more interested in heterosexual
activity.l
Post-hypnotic suggestions were made that the
feelings of change would continue subsequently.
In those patients who achieved a sufficient
depth of hypnosis to accept the suggestions
thus far described, further reinforcing sugges
tions were made. In some patients these took
the form of looking back at their homosexual
behaviour with feelings of distaste and suggest
ing at the same time that they actually experi
enced an unpleasant taste in their mouths. Con-
versely, when they looked ahead to normal
heterosexual activity, the unpleasant taste was
changed into something more attractive.
The number of sessions varied greatly, de
pending mainly on the results achieved. If a
change in sexual orientation was reached early,
the course of treatment was often quite short,
Canad. Med. Ass. J.
Feb. 11, 1967. vol. 96
perhaps six treatments spaced over two or three
weeks, with subsequent follow-ujT at less fre
quent intervals. With those patients where diffi
culty was experienced in achieving a satisfactory
depth of hypnosis, the treatment was more pro
longed and intensive. More prolonged treatment
was also necessary in those who, despite an
appreciable change in their sexual orientation,
had considerable practical difficulties in making
heterosexual contact.
Each patient was rated according to the Kin
sey scale just before treatment. This rating, as
described by Kinsey, is on a dual basis taking
into account not only overt sexual experience
but also the psychosexual reactions.
Kinsey Scale:
0.completely heterosexual.
1.mainly heterosexual, occasionally homo
sexual.
2.mainly heterosexual, more than occasion
ally homosexual.
3.equally homosexual-heterosexual.
4.mainly homosexual, more than occasionally
heterosexual.
5.mainly homosexual, occasionally hetero
sexual.
6.completely homosexual.
In this series the ratings were based on
patient's condition immediately before the treat
ment was started, and although the previous
history was taken into account, it was the sexual
orientation at the time of treatment that was
actually measured.
The follow-up program, after the initial im
provement had been achieved, often included
other treatment sessions in the hope that the
improvement could be consolidated. Many of
the patients lived a great distance away and
regular follow-up visits were difficult. Attempts
were, however, made to contact them at six-
monthly intervals after the main treatment pro
gram had ended.
The case histories of these 15 patients
as follows:
Case 1..This 19-year-old male had a history of
homosexual behaviour from the age of 12, when
he was seduced by an older boy and mutual
masturbation took place. Since that time he con
tinued homosexual activity with boys and men of
his own age, mostly as mutual masturbation.
His interest in the male body commenced at
about the age of 3 and had continued ever since.
Although he had several girl friends to whom he
became somewhat attached, he had little interest in
the female body. On one occasion he had hetero
Roper: Homosexuality 321
sexual intercourse "to what it is like". His sexual
see
much greater than to women.
attraction to men was
He was assessed as Kinsey scale 5.
Before hypnosis was begun, he had received
psychotherapy and drugs without response. He
reached a deep trance easily. Hypnosis was used
initially in 1960 as an exploratory technique: sub
sequently, however, it was suggested that he change
his attitude on sexual matters, i.e. that he find
women attractive and men less attractive.
He had seven treatments in 10 days, but the
suggestions were not as strong or as detailed as
those given later in the series; and they were not
coupled to the patient's sensations of emotional or
physical change, or to body movements.
He was seen again in 1961. He still had homo
sexual tendencies, but felt that these were "not so
strong". He was again seen in 1965, when no further
change was noted. Further treatment with hypnosis
was attempted, a total of eight sessions in two weeks,
but a deep trance could no longer be obtained and
the patient failed to improve further. He was
assessed as a mild improvement. The hypnotic depth
achieved in 1960 had been the third stage, and the
total follow-up period was five years.
Case 2..This 25-year-old man had a history of
homosexual activity from the age of 15, mainly as
mutual masturbation with other men. He also ob
tained considerable satisfaction from physical con
tact, petting etc, with other men, in which he
played a passive role. He had had no heterosexual
the contacts and felt no heterosexual desires. His Kinsey
scale was 6.
Under hypnosis the patient was only able to reach
a medium trance level (second stage) and never
experienced any post-hypnotic amnesia. Despite this
lack of hypnotic depth, it was suggested to him,
during his fifth weekly session, that his sexual
orientation would change. Subsequently he stated
that he was less attracted to boys and more at ease
with girls. These changes, however, were only
temporary, occurred directly after the hypnotic
session, lasted a few days and then gradually
weakened. Nevertheless, after two months he had
"broken off" with his boy friend and did not feel
upset about it. He was beginning to take greater
interest in girls and engaged in love-play with them
and experienced erections.
are
At the end of six months he had had 15 sessions
but had reached a plateau and could not further
increase his interest in or his activity with girls.
Hypnosis continued intermittently once each
month until he had been under treatment for 18
months and had a total of 25 sessions. At this time
he still had occasional homosexual inclinations but
stated that he could not engage in any homosexual
activity again. There had been no further increase
in his heterosexual interest and he had not had
sexual intercourse with girls. His result was assessed
as a mild improvement and this was confirmed
when no further change was noted after a two-year
follow-up.
322 Roper: Homosexuality
Case 3..This 27-year-old married man had a
history of homosexual activity from the age of 14
with mutual masturbation and anal intercourse. He
had always felt more attracted to men than to
women. He had married about five years before
being seen and had enjoyed a reasonably satisfactory
relationship with his wife for three years until, by
chance, he met a homosexual. This led to a very
strong relationship which included anal inter
course in which the patient was the active partner;
this relationship lasted for about nine months. The
attraction he had for his wife disappeared con
currently and he felt very much in love with the
other man. The Kinsey scale was assessed as 4.
He was treated with hypnosis on three successive
days and was able to reach a deep trance level.
Suggestions of change in his sexual orientation were
made; when seen a week later, he stated that a
change towards his wife was noticeable in that he
now wanted to kiss her again. Two more sessions
were given in the next two days, and this was re
peated after another week's interval.
He was not seen again until a year later, when
he stated that a number of changes had occurred
since his previous treatment. He was getting on
better with his wife and found a greater return of
his excitement with kissing her. He felt that sexual
intercourse with his wife was more satisfactory and
he was thinking less about homosexual relations. In
addition to this he felt there had been a general
change in his outlook; he was more masculine in
his approach and joined in masculine conversation
on such subjects as hunting, which he had never
done before. He was also more interested in pin-up
pictures of girls and was less flamboyant in his
dress. He seemed to be more relaxed at his work
and less easily upset by minor stress. He felt that
further homosexual activity was unlikely and he
was happy to live a normal life in the future. The
improvement was confirmed by his wife, who noted
a great change generally and in his attitude to her
self. Sex, she thought, was also much better. He
was given two further hypnotic sessions on successive
days with apparent good response.
He was not seen again until another one and
one-half years later, when it was noted that he was
maintaining his improvement. His relationship with
his wife had improved further, but he noted that,
although his sexual feelings towards her were ade
quate, he could not possibly have these towards
other women and it upset him to hear other men
boasting of their conquests. He had maintained con-
servatism in his dress, but felt the occasional return
of his homosexual ruminations at times. His result
was assessed as a marked improvement at the total
follow-up period of two and one-half years.
Case 4..This 44-year-old single man had, from
the age of 27, a history of homosexual activity with
pre-adolescent boys. The homosexual feelings had
started from the age of 13; he was attracted by
boys of the same age, or slightly younger. He had
been arrested twice for pederasty, and there had
Canad. Med. Ass. J.
Feb. 11, 1967, vol. 96
been an act of this kind just before his interview
which had prompted him to ask for help.
He had never felt attracted to women and had
had no sexual experience with them. The Kinsey
scale was assessed as 6.
Hypnosis was unsuccessfully attempted on four
occasions and he was subsequently seen at two-
monthly intervals, for supportive psychotherapy
only. The patient's attraction for pre-adolescent boys
continued and his desire for homosexual activity
was just as strong. He exercised enough caution,
however, to avoid situations which might cause
him trouble. After a follow-up period of two years
there was no change in his situation although he
found it easier to ignore his problem under every-
day conditions. He was still masturbating with
homosexual fantasies about twice a week. The result
was assessed as no improvement.
Case 5..This 32-year-old single man had a
history of homosexual activity since the age of 12
which included masturbation, anal intercourse and
feflatio, usually as a passive partner. The patient
never had any steady relationships, just "one-night
stands". He had had no heterosexual activity apart
from a certain amount of attraction to the opposite
sex, but had never got past petting. The Kinsey
scale was assessed as 5.
With hypnosis he reached a deep trance by the
fourth session at the end of the first week of treat
ment. Following suggestions made at this stage, he
noticed a change in his attitude to men, no longer
being shy and passive towards them; he felt some
increase in his attraction to women. By the end
of the second week of therapy he found, for the
first time, that he had erections when with a girl;
and he had greater self-confidence. He found a
steady girl friend and felt more and more sexually
attracted towards her. His first heterosexual inter
course took place nine months later, by which time
he had lost all his apparent attraction towards men.
He was assessed as a marked improvement. The
follow-up continued for a period of three and a half
years, during which time he married his girl friend
and found himself quite adequate and confident
sexually.
Case 6..This 21-year-old single man had a
history of homosexual activity since the age of 7
with mutual masturbation and, since the age of 17
had been both active and passive in anal inter
course. From the age of 13 to 17 he had some
heterosexual attraction but no experience. Since the
age of 17, he had experienced no attraction to girls.
He had had psychotherapy at two institutions with
out result. The Kinsey scale was assessed as 6.
With hypnosis he reached a deep trance level
after some initial difficulty.16 sessions being neces
sary in the first month. He noted a change in his
sexual attitude immediately after the suggestions.
He first noticed an indifference in his attitude
towards men and then feelings of disgust when he
thought of his past homosexuality. His improvement
Canad. Med. Ass. J.
Feb. 11,1967, vol. 96
continued during the subsequent sessions, a total
of 21 in six weeks. He felt no attraction towards
homosexuals that he recognized, and felt consider
able attraction towards women.
Follow-up contact one year later showed that the
improvement had been maintained, but he still had
not had any heterosexual experience. He was
assessed as a marked improvement.
Case 7..This 24-year-old single manhad a
history of homosexual activity since the age of 12
with mutual masturbation. He was seduced at the
age of 15 by an older man in anal intercourse. He had
carried on since that time with homosexual activities
with other boys at school and other men. He had
formed steady relationships with a number of men
at times and, at the termination of his last affair,
had become anxious and depressed and decided to
seek help. He had never experienced any sexual
attraction towards women. The Kinsey scale was
assessed as 6.
With hypnosis he reached a deep trance level by
the sixth session at the end of 10 days. Immediately
after the suggestions were made to him, he noticed
a change in his sexual attitude. He rejected homo
sexual advances from other men; he stopped fre-
quenting homosexual haunts and stated, "I don't
want it and I don't know why I don't want it." His
previous homosexual friends he found boring, their
conversation trite, and he felt their behaviour was
ridiculous.
His attitude to women changed and he felt some
sexual attraction. There was no sexual activity,
however, and the patient remained on this plateau,
feeling in a state of "sexual inertia". He was seen
approximately twice a month until a period when
he was not seen for four months. During this time,
he noticed some return of his homosexual fantasies,
particularly with masturbation, and he relapsed and
formed a homosexual relationship again. This rela
tionship was only a temporary one, however, and
he felt much less attraction to the situation than
he had on similar occasions in the past. The "affair"
ceased after a month and he resumed his hypnotic
sessions intermittently. He appeared to show a
steady improvement, and his first heterosexual inter
course took place a few months later. He found this
to be quite enjoyable and subsequently felt more
confident. He had a total of 32 sessions in 15 months
and was assessed as a marked improvement. The
follow-up period extended for two years.
Case 8..This 33-year-old man had been referred
for symptoms of depression, but homosexual prob
lems became evident during the interview. His
hornosexual activity had evidently started eight
years previously and included mutual masturbation
and fellatio. He had previously felt attracted to
women but had never had any sexual experience
with them. For the past eight years he had felt no
attraction towards them at all. The Kinsey scale was
assessed as 6.
Roper: Homosexuality 323
With hypnosis he entered into
a deep trance
state in the first session and,following suggestions,
felt a return' of his desire for
women and no longer
was attracted towards men. This took place after
only two sessions at the end of the first week. He
was given further sessions at approximately monthly
intervals, by which time he had a steady relation
ship with a girl friend for whom he felt strong
sexual desires. At the end of the follow-up period
of one his
year improvement had been well main
tained and he was assessed as a marked improve
ment.
Case 9..This 23-year-old man had a history of
homosexual activity since the age of 13, when he
had practised mutual masturbation, fellatio and anal
intercourse, both active and passive. He had been
arrested a number of times and convicted previously
for his homosexual activities with young boys. He
was referred by the legal authorities.
He was able to arouse some desire for women
and on one occasion had an erection while with a
girl, but no sex play had ever taken place. The
Kinsey scale was assessed as 6.
With hypnosis he reached a deep trance by the
fifth session at the end of the first week. He noticed
a change in his sexual orientation after suggestions
made at this time, with increased desires for women
and no longer feeling attracted to boys. Follow-up
contact one year later showed that this improve
ment had continued. He stated that he had "lost
all taste for homosexual activity" and had in fact
tested himself by going to homosexual haunts where
he felt uneasy and contemptuous of the situation.
He was assessed as a marked improvement.
Case 10..This 32-year-old man had a history of
homosexual activity since the age of 12 with mutual
masturbation. He had never felt any sexual attrac
tion to women; in fact he felt repelled by them.
The Kinsey scale was assessed as 6.
Three attempts at hypnosis were made within 10
days, but the patient was a poor subject and not
even a light trance state could be achieved. He
was finally referred to another therapist for be
haviour therapy without any change in his condition.
He was assessed as no improvement.
Case 11..This 28-year-old man had a history of
homosexual activity since the age of 21 with mutual
masturbation and active and passive anal inter
course and passive fellatio. There had been one
regular homosexual relationship which had lasted
intermittently over the previous two years. He
had had occasional sexual intercourse with girls
from the age of 19, but none for the previous six
months. He found himself much more attracted to
men. The Kinsey scale was assessed as 4.
With hypnosis he was found to be a poor subject,
and not even a light trance was possible after re
peated attempts. His homosexual activity continued
and the patient broke off treatment. The result was
assessed as no improvement.
324 Roper: Homosexuality
Case 12..This 40-year-old man had a history of
homosexual activity since the age of 21 and had two
court convictions for the offences. He looked for con-
contacts in public lavatories and washrooms and
engaged in mutual masturbation, fellatio and anal
intercourse, both active and passive. He had felt some
heterosexual attraction and married, at the age of 27,
without any previous heterosexual experience. He
maintained his sexual attraction to his wife despite
homosexual activity, but could feel no attraction to
other women. The Kinsey scale was assessed as 3.
With hypnosis he was found to be only a fair
subject and never reached a deep trance. After 16
sessions over a four-month period, there was no
marked change in his sexual behaviour and his
homosexual activity persisted. Further sessions,
where he entered a slightly deeper stage of hypnosis,
were successful in bringing about some improvement
and, from this time on, no further homosexual
episodes took place. He had a total of 23 sessions
and the follow-up period of four months showed
no further improvement. He was transferred to
another psychiatrist for behaviour therapy. He was
assessed as a mild improvement.
Case 13..This 20-year-old man had a history of
homosexual activity from the age of 12 with mutual
masturbation and fellatio which had continued
intermittently ever since.
He felt some attraction to girls, but had never
felt any strong sexual desire for them. He had
attempted to masturbate with fantasies and pin-up
pictures of women, but these efforts were not nearly
so effective as fantasies of men. The Kinsey scale
was assessed as 5.
With hypnosis he was found to be only a fair
subject, reaching a medium trance level. By the
sixth interview at the end of a month, however, he
noticed some change, which gradually increased
with continued sessions at monthly intervals. He
became more attracted to women and was having
contact with girls, including love-play. He no longer
felt an attraction for men and became nauseated
with thoughts of Homosexual activity. This im
provement, however, was not consistent and
he occasionally had homosexual ruminations. After
reading a magazine article on homosexuality which
emphasized the unlikelihood of change and the in
effectiveness of treatment, he had a further homo
sexual affair. He showed a subsequent response to
further therapy, but was still not able to achieve
a deep trance state and the suggestions were looked
upon as being only partially effective.
At the end of treatment for nine months, a total
of 17 sessions, he was referred to another hypnotist
in an attempt to improve his response to treatment.
The result was assessed as a mild improvement.
Case 14..This 35-year-old man had a history of
homosexual activity from the age of 7 which had
since continued intermittently. In the previous year
his homosexual desires had shown considerable in
Canad. Med. Ass. J.
Feb. 11,1967. vol. 96
crease. From the age of 27 he had had hetero
sexual attraction, however, and sexual intercourse
with girls. He married two years before being seen,
but had always found his wife less sexually attrac
tive than men, and this had become more apparent
in the past year. The Kinsey scale was assessed as 4.
With hypnosis he was found to be a good subject
and reached a deep trance level. He showed an im
mediate response to the suggestions with increased
sexual desire and activity towards his wife. These
changes were apparent after the first interview and
continued until he was seen again two weeks later.
He was given three subsequent sessions on consecu
tive days and the changes he had previously noted
became more apparent. He no longer had any
homosexual attraction, although there was occasional
worry that his homosexual feelings might return.
He had a total of seven sessions in all. On follow-up
one and one-half years later, his improvement,
which was assessed as marked, had been maintained.
Case 15..This 42-year-old man had a history of
homosexual activity from the age of 12 which had
continued ever since. It included mutual masturba
tion, fellatio and active and passive anal inter
course. He had had some sexual experience with
girls during his adolescence, but had not enjoyed
intercourse with them and had not felt any attrac
tion towards them since that time. The Kinsey scale
was assessed as 6.
With hypnosis he reached a deep trance level by
the sixth session after a 10-day period. After this,
he reported a marked change in his feelings and
behaviour, no longer having any homosexual desire
and now being interested in women. He had seven
sessions. At follow-up one year later, the improve
ment which was felt to be marked was confirmed.
Results
In attempting to assess the results of treat
ment each patient was classified as "no improve
ment", "mild improvement", or "marked improve
ment". This assessment was based on the reduc
tion of homosexual inclinations and behaviour;
an increase in heterosexual inclinations and be
haviour was also taken into account as added
confirmation of a change in sexual orientation.
The depth of hypnosis found significant by
other authors is also recorded for each patient
(Table I). Results of treatment are correlated
with depth of hypnosis in Table II.
Of 15 patients, nine reached the third stage
of hypnosis and eight of these showed a marked
improvement in their condition. No other pa
tients showed this degree of improvement. The
only patient who did not markedly improve in
this category was Case 1 with whom the sugges
tions used were somewhat limited. The three
patients who showed no response to hypnosis had
 Roper : HoMOSExuALrrY 325

cases when their confidence in the treatment

was undermined by outsideinterference (Case
5 was told by a minister that "he had never
seen a cure yet", and Case 13 read a similar
opinion in a magazine article).
The effects of marital status were also diffi
cult to determine. In some cases it seemed that
the married patients had advantages, not only in
at least some residual attraction for their wives,
but also because of the knowledge of previous
sexual experience and the availability of the
sexual partner.
Clinical Impressions
During the treatment of these patients a num
ber of interesting clinical observations were
no change in their symptomatology. In the three made.
patients who reached the second stage of hyp Concomitant with the limited effectiveness
nosis, there was only a mild improvement. of the therapy in Case 1 (besides the author's
inexperience) was the occurrence of muscular
tremors in the patient when a change in the
TABLE II. sexual orientation was suggested. This phe
Degree of improvement nomenon was observed in the deep stage of
Hypnotic depth hypnosis and the patient had complete post-
(stage) None Mild Marked Totals
same phenomenon
hypnotic amnesia for it. The
Nil. 3 was observed in Case 12 during the second
Stage 2. stage and the patient was not able to go
Stage 3.
any deeper. These symptoms were thought to
15 indicate non-acceptance of the suggestions, with
conflict showing itself in the physical agitation.
Because of the difficulties in assessing the Feminine mannerisms, dress, speech and gen
change produced, the value of statistical evalua eral behaviour indicated homosexual tendencies
tion of these results is doubtful. However, bear in about one-half of the patients. During therapy
ing this in mind, it can be noted that the correla no specific suggestions regarding this behaviour
tion between the depth of hypnosis and a were made, but in some patients quite marked
marked improvement was statistically significant changes were noted when the therapy was
(Table III). successful, particularly in Case 3.
Under hypnosis some patients when told to
make a fist did so with the thumb flexed and
enclosed by the fingers. As treatment proceeded
this "homosexual" fist changed to a more mascu
line one with the thumb flexed over the fingers;
no specific suggestions about this were made.
The suggestion made to some patients that they
felt a "distaste" for the homosexual behaviour
15 was quite well accepted by some of them al
X2 11.429. P<0.001.
=

though they had a posthypnotic amnesia for it.

degree of the homosexual behaviour did
The
not apparently affect the results achieved. Using
the Kinsey scale, there was no significant differ
ence between those with a high score and those
with a low score. The influence of the degree of
motivation on the results was difficult to assess.
Case 9 had marked improvement even though
he was referred by the courts and did not appear
to be highly motivated. In this respect, it was
noteworthy that deterioration took place in two
After treatment one patient spontaneously stated
that, on seeing obvious homosexuals, he felt an
awful taste in his mouth and felt like retching.
The harmful effect of doubt concerning the
effectiveness of treatment on the apparent
motivation was striking. Some had evidently
been told that there was no possibility of change
and they just had to "live with their problem".
Many had almost given up hope of any possi
bility of help. This unhappy state of mind was
often brought out more clearly during the inter-
326 Roper: Homosexuality
views under thiopental sodium (Pentothal*)
when their anguish was often forcibly expressed.
One patient exclaimed with great emotion how
he wished to "get out of the hell I am in".
The importance of opportunity for hetero
sexual behaviour was particularly obvious in
unmarried patients, who had little or no
previous heterosexual experience. In these
patients it seemed to be easier to bring about
an aversion to the homosexual behaviour than
to induce an interest in women. This feeling was
described by one patient as a state of "sexual
inertia". Another called it, somewhat appro
priately, a "no man's land". The same situation
has also been mentioned by others and Solyom
and Miller11 described it as a "sexual vacuum"
during behaviour therapy. Freund,2 in his ex
tensive review of 222 homosexuals, concluded
that treatment is most likely to be successful
when heterosexual activity is favoured and
homosexual activities are inhibited. In the
present series, conditions favouring hetero
sexual activity were often difficult to find and
more intensive hypnotic therapy was necessary
to compensate for this.
The reaction of previous homosexual com-
panions interesting. They often became
was
somewhat antagonistic towards the patient,
particularly when he showed by his behaviour
that he had changed and was no longer inter
ested in them or their topics of conversation, etc.
This situation was of some benefit to certain
patients (e.g. Case 7), particularly those who
were having some difficulty in getting through
the phase of "sexual inertia".
Discussion
The reports by Krafft-Ebing7 appeared to
demonstrate considerable improvement in homo
sexuals after hypnosis. In the data collected by
Schrenck-Notzing10 from a number of different
psychiatrists, of 27 patients treated with hyp
nosis, 21 had a "cure" or great improvement and,
of these, 19 reached a deep or moderate depth
of hypnosis. The present study confirms these
results recorded nearly 100 years ago, if one
bears in mind the possible differences in selec
tion, treatment techniques and assessment of
change.
The results of treatment with hypnosis suggest
that in some patients inherent tendencies and
the effects of early environment may be less
important than the immediate situation. Regard
less of constitution and previous circumstances,
some of these patients can respond to treatment
and be helped to lead normal and happy lives.
?Abbott.
Canad. Med. Ass. J.
Feb. 11,1967, vol. 96
It seems that these results can be achieved as
easily in certain patients with a high homosexual
rating (Kinsey scale) as in those with a lower
rating.
Feminine characteristics are often considered
to support the hypothesis constitutional basis
of
for homosexuality. The fact that these charac
teristics did show a change with successful treat
ment indicated that they should be considered
more as secondary effects than as expressions of
inherent and unchanging factors.
That treatment with hypnosis is so effective in
some of these people raises other points of inter
est. Some may ascribe these results to other
causes such as the "transference situation". The
fact that the third stage of hypnosis apparently
has to be reached to obtain the best results
indicates that strong suggestion is necessary.
Although there are differences between hypnosis
and other situations where suggestion is an im
portant factor, there is no doubt that radical
changes of behaviour can occur whenever the
effects of suggestion are sufficiently strong. The
religious and political conversion experiences so
well described by Sargant9 are good examples
of the extraordinarily powerful effects that can
occur when strong suggestive techniques are
used and the more rational functions of the
brain are temporarily held in abeyance.
The short-lived and temporary results of sug
gestion are, however, well known and can be
illustrated in everyday life by advertisements,
political speeches, etc. From the clinical point
of view, the syndrome of folie a deux is a good
example of the return to rational behaviour after
repetitive suggestion has been in operation per
haps for many years. The return of normal
mental functioning and the disappearance of
delusions etc, after removal from the influence
of the psychotic partner, can be attributed, at
least in part, to the termination of the suggestion
and a return to the use of more rational mental
processes.
To maintain the phenomena irfduced by sug
gestion, it seems that the suggestion must be re
peated at frequent intervals or that some sort of
explanation must be included with the sugges
tion so that it becomes more acceptable to sub
sequent rational reasoning. The clinical results
of coupling suggestions with some sort of ra
tional explanation have been described in the
treatment of exhibitionism.8 The same tech
niques were used in the treatment described
in this paper.
The combined technique of strong suggestions
of change when the patient is in a highly sug-
gestible state coupled with explanations which
the patient can subsequently accept as rational
Canad. Med. Ass. .*
Feb. 11, 1967, vol. 96
may be one of the most effective methods of
dealing with homosexuality and other problems.
It should be further emphasized that in selec-
tion we tried to exclude patients in whom the
homosexual behaviour was a symptom of a defi-
nite underlying illness. This should be con-
sidered when comparing these results with other
studies where this exclusion does not apply.
CoNcI.usIoN
Experience with these 15 patients indicates
that, in some homosexuals, hypnosis may well
produce more satisfactory results than those
obtainable by other means. Patients who become
deeply hypnotized seem to have a greater
chance of improvement. The possibility of im-
provement is also increased by certain environ-
mental factors which make it easier for the pa-
tient to take up heterosexual patterns suggested
under hypnosis.
The assessment of change in these cases was
a clinical one and included the patient's subjec-
tive attitude as well as his subsequent behaviour.
However, objective measurements of change
would assist in the planning and conduct of
therapy.
ROPER: HOMOSEXUALITY 327
SUMMARY
The effects of hynotherapy on homosexuality are
described. Fifteen patients, selected from a general
psychiatric practice, were investigated and treated.
The results of the treatment were assessed and
correlated with the depth of hypnosis reached. It
was concluded that homosexual behaviour can be
changed 'by hypnotherapy if a deep trance level of
hypnosis is reached.
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